Yes, it is possible to control the HIV/AIDS pandemic.
Of the different forms of transmission, sexual transmission is the most common, in addition to sharing contaminated material, such as syringes and needles. However, the transmission of the virus from mother to child, usually at the time of childbirth or during breastfeeding, constitutes a significant public health problem worldwide. The latter is called vertical transmission.
Before the advent of antiretroviral drugs used in the treatment cocktail, which block viral multiplication, around one in three children born to mothers living with HIV were infected.
Huge suffering for everyone involved. The discovery of such a diagnosis had an impact on the entire health system, on the family and, mainly, on the child who was susceptible to serious health problems, and could die from opportunistic diseases in a large percentage of cases.
As soon as it appeared, AZT was used in an attempt to prevent maternal-to-child transmission, with significant results. However, studies have shown that it was essential for the mother to be able to control the multiplication of the virus with the treatment cocktail, especially at the time of delivery.
Vertical transmission rates have been falling over time. Weapons were available to prevent new cases in children. The task, however, did not seem so easy.
How do you know where pregnant women living with HIV are? How to get the treatment to everyone? How to make the treatment result in virus control? And newborns, how can everyone born to mothers living with HIV take the prophylactic medicine during the first month of life?
Positive results would only be possible with well-coordinated actions: health surveillance, availability of tests, access to health services (since the vast majority of Brazilian families depend exclusively on the SUS) and long-term follow-up.
This is what the Program for Sexually Transmitted Infections of the Health Department of the city of São Paulo achieved.
The first metropolis in Latin America to achieve certification of the elimination of vertical transmission of HIV, in 2019, São Paulo maintained the feat of its prevention program, meeting in 2021 a series of criteria established by the Pan American Health Organization (PAHO ) and the World Health Organization (WHO).
This is an extraordinary achievement, considering the difficulties of public health programs during the Covid-19 pandemic, which made it difficult for pregnant women to access medical care.
Added to others, these results lead us to believe that the elimination of HIV transmission is possible, including sexual transmission. The tools are in place: tests, identification of people living with HIV, use of barrier or medication prevention means and, above all, adequate treatment for all those living with the virus.
In this way, the chain of transmission is broken and the pandemic tends to regress. This is already evident in the state of São Paulo, with a drop in the number of new cases every year.
Controlling the HIV/AIDS pandemic has become a political-administrative issue. Although everyone is waiting for new contributions from science, such as improvements in medicines, vaccines and even a cure, the resources we have, combined with administrative efficiency, indicate that we can get there. The municipality of São Paulo proved to us that it is.
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